Dysfunctional uterine bleeding laboratory findings

Dysfunctional uterine bleeding Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Arooj Naz, Vishnu Vardhan Serla M.B.B.S. [2]

Overview

Women afflicted with dysfunctional uterine bleeding commonly present with CBC changes, particularly changes in red blood cells. Significant laboratory findings may include coagulation profile changes, genitourinary findings, hormonal levels as well as biomedical markers to detect underlying malignancies.

Laboratory Findings

A pregnancy test should be done to rule out pregnancy related complications leading to dysfunctional uterine bleeding by testing for human chorionic gonadotropin.

CBC

1. RBC: Iron deficiency anemia may be seen; Microcytic, hypochromic anemia with central pallor and target like cells

   

   Iron deficiency anemia; PMID: 28846348

2. WBC: leukocytosis: normal
3. Platelets: changes in platelet count may be seen if coagulopathy is the underlying cause

Coagulation Profile

• Platelets: changes in platelet count may be seen if coagulopathy is the underlying cause
• PT, aPTT and bleeding time vary depending on the underlying coagulopathy
• Normal labs indicate a lack of bleeding disorders as the underlying cause of DUB
• Clotting factor assays

Electrolytes

• no significant changes

Genitourinary Tests

• Pap smear
• Peripheral smear

Hormonal Levels

• TSH
• Prolactin
• Dehydroepiandrosterone-sulfate (DHEA-S)
• Testosterone
• Estradiol
• Follicle stimulating hormone (FSH)
• Luteinizing hormone (LH)
• Serum progesterone

Biomedical Markers

Markers may be helpful in diagnosing an underlying endometrial malignancy. These include:

• Carbohydrate antigen 125 (CA 125)
• Estrogen and progesterone receptor expression
• Presence of mutations (e.g., PTEN, TP53)
• E-cadherin (CDH1)
• Neural cell adhesion molecule L1 (L1CAM)